What is IVIG or Intra Venous Immunoglobulin 19 Facts
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1. What is IVIG or Intravenous Immune Globulin?
IVIg is a collection of antibodies called IgG or Immuno Globulin-G
IgG is a naturally made by plasma cells in our body, IgG antibody, also known as an immunoglobulin-G is a large Y-shaped protein used by the immune system to neutralize foreign objects like viruses and bacteria.
IVIg is formed by taking IgG antibodies from about 20,000 donors and mixing them together. infusion of IVIg has proven effective in immune deficiency disorders, including nearly all autoimmune conditions like CIDP and GBS. The sooner you treat the patient with IVIg the better the results. There is a short window of opportunity usually within the first 18 months after the diagnosis. Treatment with IVIg within the window period is likely to halt the progress of the disease. Example is Kawasaki disease, once IVIg is used full recovery follows.
After being exposed to toxins and poisonous chemicals including carbon monoxide the body's immune system may mount a attack on the body. This autoimmune attack can be halted by any anti-inflammatory treatment including IVIg.
2. How does IVIG work?
IVIg is used in immune deficiency where the body does not make enough antibodies, IVIG supplies them. For autoimmune disorders like GBS & CIDP, there is a abnormal antibody (autoantibody) being formed which is inactivated by IVIG.
Patients with autoimmune disorders like CIDP also are deficient in antiidotype antibodies. IVIG supplies them. Antiidotype antibodies are normal antibodies which are produced in the absence of any antigen. They are capable of inactivating many different types of antigens.
3. How long does it take to a IVIG treatment to have a effect?
After IVIg is infused patients may see a response in 24- 48 hours. Some patients will have to wait 3-4 weeks to see an effect. In a few no effect may be seen. If 4-5 cycles of IVIg do not show any response then try a different approach like add intravenous steroids and antibiotics.
Everyone is slightly different as it depends on how long has the disease process been going on. The sooner one treats it the disease the faster the response.
4. Why is IVIG so expensive?
IVIg is obtained from plasma donors who are paid then the plasma is sent to a processing centers for mixing, antibody removal, chemical treatment and filtration to remove viruses. This is followed by the products to be freeze dried. All this ends up for IVIG to be priced at $ 48 to $ 60 a gram (cost price of IVIg). A single infusion of IVIg may cost about $3000 for a child to $10,000 for adults. For a child the cost is lower as a small IVIg dose is used. If you have insurance you will see the cost of infusion may go to 100,000.
The cost of IVIg in India & Pakistan $46 a gram, lower prices are found in China where the manufacturer will see IVIg for $10- a gram. This price has doubled in the last year. A pharmacy in Bangladesh Dhaka sells the cheapest IVIg 5 dollars a bottle of Baygam made in Germany. At cidpusa.org we ordered and tested this IVIg was 100% authentic. (infusions were done in Dhaka testing in Lahore). FDA does not allow foreign IVIg into USA.
5. How is IVIG administered?
IVIG is mixed in a bag and a tube runs from it to a vein usually in the arm. The recommended way to infuse includes a pump. Usually IVIg is infused at a rate of 100 cc/ hour to 200 cc/ hour.
The rate of IVIg is reduced for any problems such as headaches, rash, fatigue, hypertension or hypotension. For an adult's IVIg infusion is usually given over 5 to 6 hours. Dr Dalakas mentioned in his study that precise control of IVIG infusion is required.
6. What are the common side effects OF IVIG?
IVIg at times causes patients to get a headache, which is more common in females with a history of Migraines. after IVIg infusion some Patients may experience fatigue similar to getting a Flu, which is due to antibodies interaction. IVIg may also cause to patients get a rash and doctors recommended they take Benadryl or even steroids to avoid this. Remember their are a lot of antibodies and some may result in odd reactions. Kidney failure may result after IVIg if less fluids are given. Stroke or heart attack can happen after IVIg if the IVIg solution is pumped in at a fast rate.
A severe headache with a stiff neck after IVIg may be due to aseptic meningitis.
Variation in blood pressure, shortness of breath, back pain can also be seen after IVIg infusion. Serious conditions like encephalitis, myocarditis have been seen.
7. How can one reduce the side effects of IVIG?
Remember to drink eight glasses of water a day for hydration before starting the IVIg treatment and continuing this a month after the last IVIg infusion. Some doctors recommend to take a baby aspirin to prevent thrombophelebitis. Patients need to check with their doctors if they can use aspirin and should not take this if they are on coumadine or have bleeding disorders or if they have a history of gastric ulcers. Doctors use Premedication to help reduce side effects. Some recommend that one should take Tylenol or other NSAID for prevention of headaches and pains. Use a benadryl capsule for a rash and even to relax during the treatment. Using low dose prednisone will reduce side effects like headaches.
8. Where is the IVIG treatment given?
IVIg can be given at home, in a doctors clinic or a hospital outpatient unit. Some patients have even taken IVIg at work.
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